In case of shallow disturbances of water and electrolyte balance and protein metabolism, an enteral pathway can be used to correct the existing disorders. Patients are prescribed abundant drinking (in the absence of contraindications), high-calorie diet with high protein content, means that stimulate appetite and improve digestion, are introduced into the diet rich in potassium products (cottage cheese, dried fruit, fruit juices), complementing them with the introduction of potassium orotatate and panangin. In recent years, the introduction of fluids and high-calorie nutrient mixtures using a thin nasoduodenal or nasointestinal probe has begun in the clinic for these purposes, which has expanded the capabilities of the enteral correction method for water-electrolyte and metabolic disorders and limited indications for infusion therapy.
Blood transfusions for the correction of hypovolemia and anemia in the preoperative period in the clinic, as a rule, are not used. Indications for transfusion of erythrocyte-containing transfusion media are given only in cases when a decrease in the oxygen capacity of the blood can become critical, with a deficit of circulating blood volume of more than 20% of the due and a deficit of the globular volume of more than 30%, and a decrease in hemoglobin concentration of less than 100 g / l. Recently, when determining indications for blood transfusions, the value of oxygen transport is taken into account. In the choice of erythrocyte-containing transfusion media, it is necessary to give preference to the component transfusion therapy and transfusion of only fresh blood.
The absence of hypoproteinemia and severe anemia in most patients with lung cancer makes it possible to use the preoperative period to procure autologous blood, autoplasma using single or multiple plasmapheresis, autologous bone marrow, and in recent years one-time continuous erythrotapheresis . Work on the preparation of blood transfusion media is planned in such a way that from the time of the last intervention to the operation took at least 5 – days.
In the preoperative period, the study of the state of the digestive and urinary systems is usually carried out on the basis of data obtained during clinical and laboratory examinations. According to the testimony performed additional radiological, endoscopic and laboratory tests.
After operations on the lungs, the function of the gastrointestinal tract changes significantly. This makes it necessary to take into account, prior to the operation, the presence of chronic diseases of the stomach and duodenum (chronic gastritis, ulcer), which, as a rule, worsen in the postoperative period, disrupt enteral nutrition and may cause serious complications (bleeding, perforation). In patients with hyperacid state
quite often acute (stress) ulcers develop after surgery. The frequent association of lung cancer with gastric ulcer and duodenal ulcer, has led some authors to consider peptic ulcer as paraneoplastic syndrome. If patients have these diseases, even without exacerbation, as well as a hyperacid state, it is necessary to begin active anti-ulcer therapy in the preoperative period, which should be continued after surgery.